Endocrine Abstracts

Introduction: Testosterone replacement therapy is the standard treatment for hypogonadism. However, there are also serious side effects which clinicians should be aware of. Here we present a case of unusual side effect related to testosterone therapy.Case history: A 90 year-old gentleman attended A&E with gradually worsening confusion and dyspnoea. His breathing had deteriorated in the last week with marked decrease in exercise tolerance. Investigati...

An 83-year-old gentleman was referred to the endocrine clinic with incidentally found abnormal thyroid function tests (TFT): TSH <0.02 (0.2–4.0 mU/l), free T4 20.4 (9–19 pmol/l), and free T3 7.6 (2.5–5.7 pmol/l). His TFT done 6 months previously were normal with TSH 1.21 mU/l and FT4 11.8 pmol/l. His past medical history included BPH, peripheral vascular disease and chronic kidney disease (CKD), and medications were tamsulosi...

Introduction: The reason for weight gain is multifactorial. Effective intervention can only be incorporated if the underlying cause is evaluated correctly. Here we present a lady with Addison’s disease who gain significant weight and was helped to lose weight using a novel approach.Case-Report: 42 year-old lady was referred to our weight-management service as she was unsuccessful in losing weight. Detailed evaluation in the obesity clinic revealed t...

Introduction: Radioactive iodine (RAI) is an effective and widely used treatment for thyrotoxicosis. Post-radioiodine thyrotoxicosis is a well-known side effect of RAI. This is usually mild and easily controlled mostly with beta blockers but sometimes needs anti-thyroid drugs (ATD).Aim of the study: To assess the incidence and predictors of post-radioiodine thyrotoxicosis.Methods: Retrospective analysis of 86 patients who had RAI t...

Background: Hypercortisol states present a diagnostic conundrum. Other conditions such as cyclical and subclinical Cushings pose additional challenges. We report a complex clinical presentation of thymoma with coexisting subclinical Cushing’s.Case report: A 65-year-old man presented to chest clinic with breathlessness and anterior mediastinal mass on CXR. CT scan demonstrated a 7.5 cm probable thymoma and bilateral adrenal masses of varying sizes up...

Background: Elevated TSH with raised free T4 (fT4) presents a diagnostic challenge. Symptomatically they vary across the spectrum of thyroid status. We report cases with these dilemmas.Case 1: Seventy four year old was referred with 5 years of TSH ranging between 4.9–7.9 mIU/l (0.2–4.0), fT4 18.5–27 pmol/l (9.0–19) and free T3 (fT3) 4.5–12 pmol/l (2.5–5.7). Thyroid perox...

Introduction: Optimising management of diabetes in school is critical especially with more children being commenced on intensive insulin regimens. Partnership between families, school and caregivers is essential to enhance safety and satisfaction with the educational experience for students.Methodology: We gathered information on facilities in schools for children with T1D from our district hospital by telephonic questionnaire. The questions related to p...

Insulinomas are rare neuroendocrine tumours with an estimated incidence of up to four new cases per mill./p.a. Most tumours are benign, <2 cm and arise from the islets of Langerhans.Typically patients present with Whipple’s triad: symptoms of hypoglycaemia, caused by fasting or exercise, low plasma glucose and symptoms relieved by Food. The diagnosis is confirmed by high insulin and c-peptide levels, inappropriately high for prevailing glucose.<...

Aim: Short Synacthen test has been widely used screening test for assessment of hypothalamo-pituitary-adrenal axis (HPA). The most widely used is 30 min plasma cortisol Post synacthen. We have compared 30 min cortisol with 60 min for assessment of the HPA axis of patients with known endocrine disorders and on long term steroid, opiate use and obesity (non endocrine disorder).Method: Cortisol Response to 30 and 60 min post synacthen were measured in rando...